Comorbidity patterns and health-related quality of life in a cohort of Australian women cancer survivors

This study aimed to identify dominant comorbidity patterns among women cancer survivors and examine how these patterns relate to health-related quality of life (HRQL). 1544 participants (born 1946–1951) from the Australian Longitudinal Study on Women’s Health diagnosed with cancer during the follow-up period from 1993 to 2019 were included. HRQL is measured with Short Form-36 included in the survey. Latent class analysis was applied to identify comorbidity patterns, and linear regression was used to assess their association with HRQL domains, adjusting for demographic factors. Five distinct comorbidity classes were identified: relatively healthy (n = 880, 57%); hypertension and arthritis (n = 278, 18%); arthritis and osteoporosis (n = 139, 9%); respiratory conditions (n = 170, 11%); and complex multimorbidity (n = 93, 6%). Compared to the relatively healthy class, women in all other classes had significantly lower average HRQL (p < 0.01). For example, the classes’ adjusted mean score for general health domain varied: relatively healthy (mean = 70.8, reference), hypertension and arthritis (mean = 63.1, 95% CI = 59.9, 66.3), arthritis and osteoporosis (mean = 60.0, 95% CI = 55.8, 64.1), respiratory conditions (mean = 60.9, 95% CI = 57.2, 64.7), and complex multimorbidity (mean = 48.6, 95% CI = 43.4, 53.8). Women in the complex multimorbidity class had the lowest HRQL across all domains: physical functioning adjusted mean difference from relatively healthy (AMD=− 22.2 and 95% CI − 27.4, − 17.0), mental health (AMD=-11.4, 95% CI=− 15.4, -7.5). Comorbidity patterns varied substantially among women cancer survivors and were strongly associated with differences in HRQL. Survivors with complex multimorbidity experienced the greatest impairments. Incorporating comorbidity profiling into survivorship care may help identify high-risk groups and support targeted interventions to optimise quality of life. More and more people are surviving cancer, but many also live with other long-term health conditions, which can affect their daily life and wellbeing. We carried out this study to better understand how these conditions cluster together and how they impact the quality of life among cancer survivors. Our study looked at whether some health conditions tend to occur together in Australian women cancer survivors, and how these different combinations affect how people feel physically and emotionally. We found that certain patterns of long-term conditions, such as high blood pressure, arthritis, and respiratory diseases, are common among cancer survivors. Women cancer survivors with more complex health issues generally reported lower health-related quality of life across many areas, including general health, bodily pain, physical functioning, and mental wellbeing. These findings suggest that cancer survivors with multiple long-term conditions may need more support to manage their health and improve their quality of life. Health services should consider these patterns when planning care, so survivors get the right help for their unique health needs.